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My doctor tells me if I see a physical therapist for my back pain, I'll save money in the long run. I tell her if I don't see a physical therapist at all, I'll save even more money. What do you think?

It is true that you will spend more money seeing a physical therapist than if you didn't go at all -- at least in the short-term. But it may not be worth it when you hear the results of a new study from the University of Utah. They found that early referral to physical therapy for mechanical low back pain was linked with: 1) lower overall health care costs, 2) fewer doctor visits, 3) less use of advanced imaging (CT scans, MRIs), 4) reduced risk of surgery and injections, and 5) decreased use of narcotic (opioid) medications. The study was done by reviewing patient records from a national database of employer-sponsored health plans. Although the study was conducted by physical therapists, they had no influence on who among the 32,070 patients studied was sent to physical therapy (PT). They were just reporting trends observed from analyzing the data. Of the 32,070 patients who were diagnosed with low back pain as the main complaint, seven per cent were referred to PT. About 1100 patients received early PT (within 14 days of their doctor visit). The remaining 975 patients were categorized as delayed PT. They were sent to PT between 15 and 90 days after the primary care index (first) visit. What they found was if you live in the Northeast or West (United States), are covered by a preferred provider plan, and you are not taking narcotic medications, then you would be more likely to see a physical therapist early in the episode of your back pain. With early PT, you would be less likely to have surgery or injections and the cost savings would be nearly $3,000.00. A second feature of the study was to compare cost savings for patients depending on how they were treated. There are Clinical Practice Guidelines (CPGs) based on research evidence that dictate how patients with mechanical low back pain should be treated. Health care providers who follow those guidelines (guided exercise and self-management) were referred to as adherent. The second category (nonadherent) described patients who received care outside the guidelines such as hot packs, cold therapy, ultrasound. Costs associated with care according to the Guidelines were lower than nonadherent care. Each patient in the adherent group (treated according to the Guidelines) saved (on average) $1,374.00. In summary, patients receiving early physical therapy for low back pain (within two-weeks of the episode) were less likely to need more invasive treatment with injections or surgery. Costs were less compared with patients referred later, especially if treatment followed the current published Clinical Practice Guidelines.

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